Life Cycle Of A Health Insurance Claim


Life Cycle Of A Health Insurance Claim
Life Cycle of a Health Insurance Claim introduces the student to all of the steps involved in processing of an insurance claim. The new CMS-1500 claim form (rev-02-12) for professional claims and its requirements are covered. The student will learn various requirements needed to complete the new CMS-1500 form and how they affect payments. Included in this course are NPI numbers, modifier placement, and secondary insurance information. Also covered is medical terminology relating to the submission and payment of insurance claims. The student is walked through the entire process of an health insurance claim from the gathering of information for the claim to insuring full payment from all parties involved for the service. Also covered are the tracking of the claims process and the rules of various insurance carriers for timely filing of insurance claims.



Topics Covered

  • Gathering information for the insurance claim
  • Completing the CMS 1500 (02-12) Box by Box
  • Submitting the claim to the insurance carrier
  • Electronic claims
  • Paper claims
  • Reducing delays in processing claims
  • Posting payments
  • EOBs
  • ERAs
  • Tracking the insurance claim
  • Working aging reports
  • Working clearinghouse reports
  • Using Insurance carrier websites for claim status
  • Calling insurance carriers
  • Automated phone systems for checking status
  • Handling remaining balances after insurance payment
  • Secondary and tertiary insurance claims
  • Timely filing rules
  • Patient Billing
  • Medical records
  • Electronic health records
  • Electronic Prescribing


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Course Tuition $129

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